Beyond Titles: The Need to Reduce Prescribing Variation of Potentially Inappropriate Medications Among All Clinicians
Authors: Michelle S. Keller, Catherine A. Sarkisian
Journal: Annals of Internal Medicine (2023)

Editorials24 October 2023Beyond Titles: The Need to Reduce Prescribing Variation of Potentially Inappropriate Medications Among All CliniciansMichelle S. Keller, PhD, MPH, Catherine A. Sarkisian, MD, MSHSMichelle S. Keller, PhD, MPHDivision of General Internal Medicine, Department of Medicine, and Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, and Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, Catherine A. Sarkisian, MD, MSHSDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, and VA Greater Los Angeles Healthcare System, Geriatric Research Education and Clinical Center (GRECC), Los Angeles, CaliforniaAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-2556 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Shortages of primary care physicians across the country, particularly in medically underserved areas, have led policymakers to increase the scope of practice for nonphysician clinicians, such as nurse practitioners (NPs). In many states, this includes the ability to prescribe medications. In their article, Huynh and colleagues (1) address concerns around the quality of care for older adults by asking the following question: Compared with primary care physicians, do NPs have worse rates of potentially inappropriate prescribing for older adults?The short answer is no, NPs are no worse than primary care physicians when it comes to inappropriate prescribing for older ...References1. Huynh J, Alim SA, Chan DC, et al. Inappropriate prescribing to older adults by nurse practitioners and primary care physicians. Ann Intern Med. 2023;176:1448-1455. doi:10.7326/M23-0827 LinkGoogle Scholar2. Quinn KL, Campitelli MA, Diong C, et al. Association between physician intensity of antibiotic prescribing and the prescription of benzodiazepines, opioids and proton-pump inhibitors to nursing home residents: a population-based observational study. J Gen Intern Med. 2019;34:2763-2771. [PMID: 31576508] doi:10.1007/s11606-019-05333-8 CrossrefMedlineGoogle Scholar3. Evans CT, Fitzpatrick MA, Poggensee L, et al. High prescribing of antibiotics is associated with high prescribing of opioids in medical and dental providers. Pharmacotherapy. 2022;42:716-723. [PMID: 35869691] doi:10.1002/phar.2720 CrossrefMedlineGoogle Scholar4. Damschroder LJ, Reardon CM, Widerquist MAO, et al. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17:75. [PMID: 36309746] doi:10.1186/s13012-022-01245-0 CrossrefMedlineGoogle Scholar5. Cabana MD, Rand CS, Powe NR, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458-1465. [PMID: 10535437] doi:10.1001/jama.282.15.1458 CrossrefMedlineGoogle Scholar6. Maust DT, Lin LA, Blow FC, et al. County and physician variation in benzodiazepine prescribing to Medicare beneficiaries by primary care physicians in the USA. J Gen Intern Med. 2018;33:2180-2188. [PMID: 30251216] doi:10.1007/s11606-018-4670-9 CrossrefMedlineGoogle Scholar7. Chou L-N, Kuo Y-F, Raji MA, et al. Potentially inappropriate medication prescribing by nurse practitioners and physicians. J Am Geriatr Soc. 2021;69:1916-1924. [PMID: 33749843] doi:10.1111/jgs.17120 CrossrefMedlineGoogle Scholar8. Xiong GL, Filshtein T, Beckett LA, et al. Antipsychotic use in a diverse population with dementia: a retrospective review of the National Alzheimer's Coordinating Center Database. J Neuropsychiatry Clin Neurosci. 2015;27:326-332. [PMID: 26488486] doi:10.1176/appi.neuropsych.15010020 CrossrefMedlineGoogle Scholar9. Dore S, Weleff J, Anand A, et al. Race, economic status, and disparities in the receipt of benzodiazepine prescriptions in a large primary care sample. Gen Hosp Psychiatry. 2023;85:28-34. [PMID: 37729721] doi:10.1016/j.genhosppsych.2023.09.002 CrossrefMedlineGoogle Scholar10. Health Resources & Services Administration. Health workforce shortage areas. Accessed at https://data.hrsa.gov/topics/health-workforce/shortage-areas on 19 September 2023. Google Scholar Author, Article, and Disclosure InformationAuthors: Michelle S. Keller, PhD, MPH; Catherine A. Sarkisian, MD, MSHSAffiliations: Division of General Internal Medicine, Department of Medicine, and Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, and Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CaliforniaDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, and VA Greater Los Angeles Healthcare System, Geriatric Research Education and Clinical Center (GRECC), Los Angeles, CaliforniaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-2556.Corresponding Author: Catherine A. Sarkisian, MD, MSHS, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 1100 Glendon Avenue, Suite #710, Los Angeles, CA 90024; e-mail, csarkisian@mednet.ucla.edu.This article was published at Annals.org on 24 October 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInappropriate Prescribing to Older Patients by Nurse Practitioners and Primary Care Physicians Johnny Huynh , Sahil A. Alim , David C. Chan , and David M. Studdert Metrics Current Issue November 2023Volume 176, Issue 11 Page: 1548-1549 Keywords Cohort studies Drugs Elderly Geriatrics Information storage and retrieval Medicare Nurses Primary care physicians Safety ePublished: 24 October 2023 Issue Published: November 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...